Sliding Scale Membership Application
Where are you located (city, state, country)?
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Section 2: Your Intention & Needs
What draws you to this membership space?
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What are you currently navigating in your life or healing journey that makes this space feel like the right fit for you?
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What amount are you currently able to contribute per month for this membership (0-111 USD)? (Note: This is a pay-what-you-can space. Please choose an amount that feels honest and respectful to both of us.)
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Section 3: Commitment & Alignment
Do you feel ready and willing to attend at least 50% of the live sessions each month as best you can?
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Do you feel ready and willing to attend at least 50% of the live sessions each month as best you can?
Are you open to re-evaluating this arrangement after 6 months?
This pay-what-you-can space is offered with love, trust, and mutual respect. To ensure this support continues to serve both of us well, we’ll re-evaluate your spot every 6 months.
This doesn’t mean your access will be taken away, it simply creates space to check in, reflect on your experience, and explore what feels most aligned moving forward.
Life is always changing, and so are our needs. If your financial situation improves, you may choose to shift into the full rate to support someone else. If you still need support, I’m happy to continue our arrangement.
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Are you open to re-evaluating this arrangement after 6 months?
This pay-what-you-can space is offered with love, trust, and mutual respect. To ensure this support continues to serve both of us well, we’ll re-evaluate your spot every 6 months.
This doesn’t mean your access will be taken away, it simply creates space to check in, reflect on your experience, and explore what feels most aligned moving forward.
Life is always changing, and so are our needs. If your financial situation improves, you may choose to shift into the full rate to support someone else. If you still need support, I’m happy to continue our arrangement.
Section 4: Agreement & Signature
Mutual Agreement & Integrity Statement
Read this aloud or to yourself before checking the box:
By submitting this form, I agree to honor this pay-what-you-can space with presence, communication, and mutual respect. I understand this is a trust-based offering designed to support those in genuine need, and I am committed to showing up as best I can. I also understand this agreement will be revisited after 6 months to ensure alignment for both of us.
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Mutual Agreement & Integrity Statement
Read this aloud or to yourself before checking the box:
By submitting this form, I agree to honor this pay-what-you-can space with presence, communication, and mutual respect. I understand this is a trust-based offering designed to support those in genuine need, and I am committed to showing up as best I can. I also understand this agreement will be revisited after 6 months to ensure alignment for both of us.
Please provide your signature below:
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